Department of General Surgery. Summa Health - Akron City Hospital, Akron, OH.
Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
JSLS. 2022 Jan-Mar;26(1). doi: 10.4293/JSLS.2021.00083.
Laparoscopic adrenalectomy is now the preferred approach for most adrenal tumors. As minimally invasive surgery departments gain familiarity with the robotic platform, the safety profiles and efficacy of robotic adrenalectomy has been an area of continued discussion. The objective of this study is to outline our experience with transitioning to the robotic platform and determining the effectiveness and safety of transperitoneal robotic adrenalectomy.
We performed a single-center, retrospective review of 37 patients who underwent transperitoneal robotic adrenalectomy between August 1, 2010 and August 31, 2020. Outcomes included patient morbidity, hospital length of stay, operative time, estimated blood loss, gland volume, pathology, and postoperative complications.
Sixty-five percent of the total robotic adrenalectomies were of the left adrenal gland. The average operating room time was 213 minutes. The average gland volume was 71 cm, estimated blood loss was 74 mL and length of stay was 1.4 days. There were no significant differences in outcomes between the right and left total robotic adrenalectomies. Approximately one-third of our cohort had an adrenal cortical adenoma, while only one patient had adrenal cortical carcinoma. Four patients experienced postoperative complications that resulted in unplanned hospital readmissions and there was one mortality.
Although the standard of care for most adrenal tumors is laparoscopic resection, our 10-year experience has shown that robotic adrenalectomy is highly effective and can be a valuable tool in the community and academic setting.
腹腔镜肾上腺切除术现在是大多数肾上腺肿瘤的首选方法。随着微创外科科室对机器人平台的熟悉，机器人肾上腺切除术的安全性和疗效一直是讨论的焦点。本研究的目的是概述我们过渡到机器人平台的经验，并确定经腹腔途径机器人肾上腺切除术的有效性和安全性。
我们对 2010 年 8 月 1 日至 2020 年 8 月 31 日期间接受经腹腔途径机器人肾上腺切除术的 37 例患者进行了单中心回顾性研究。研究结果包括患者发病率、住院时间、手术时间、估计失血量、腺体体积、病理和术后并发症。
65%的总机器人肾上腺切除术为左肾上腺。平均手术时间为 213 分钟。平均腺体体积为 71cm，估计失血量为 74ml，住院时间为 1.4 天。右、左全机器人肾上腺切除术的结果无显著差异。我们的研究对象中有近三分之一患有肾上腺皮质腺瘤，只有 1 例患有肾上腺皮质癌。4 例患者发生术后并发症，导致非计划住院再入院，其中 1 例死亡。
尽管大多数肾上腺肿瘤的标准治疗方法是腹腔镜切除，但我们 10 年的经验表明，机器人肾上腺切除术非常有效，在社区和学术环境中可以是一种有价值的工具。
